Ciprofloxacina Uses

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How do you administer this medicine?

What is Ciprofloxacina?

Ciprofloxacina is used to treat bacterial infections in many different parts of the body. Ciprofloxacina oral liquid and tablets are also used to treat anthrax infection after inhalational exposure. Ciprofloxacina may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.

Ciprofloxacina extended-release tablets are only used to treat urinary tract infections, including acute uncomplicated pyelonephritis.

Proquin® XR tablets are only used to treat uncomplicated or simple urinary tract infections (acute cystitis).

Ciprofloxacina belongs to the class of drugs known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, Ciprofloxacina will not work for colds, flu, or other virus infections.

Ciprofloxacina is available only with your doctor's prescription.

Ciprofloxacina indications

infoAn indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Ciprofloxacina is indicated for the treatment of infections caused by susceptible isolates of the designated microorganisms in the conditions and patient populations listed below.

Uncomplicated Urinary Tract Infections (Acute Cystitis)

Ciprofloxacina is indicated for the treatment of uncomplicated urinary tract infections (UTIs) caused by Escherichia coli, Proteus mirabilis, Enterococcus faecalis, or Staphylococcus saprophyticus.

Because fluoroquinolones, including Ciprofloxacina, have been associated with serious adverse reactions and for some patients uncomplicated UTI (acute cystitis) is self-limiting, reserve Ciprofloxacina for treatment of uncomplicated UTIs (acute cystitis) in patients who have no alternative treatment options.

Complicated Urinary Tract Infections, And Acute Uncomplicated Pyelonephritis

Ciprofloxacina is indicated for the treatment of complicated urinary tract infections (cUTI) caused by Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Proteus mirabilis, or Pseudomonas aeruginosa and acute uncomplicated pyelonephritis (AUP) caused by Escherichia coli.

Limitations Of Use

  • The safety and efficacy of Ciprofloxacina in treating infections other than urinary tract infections has not been demonstrated.
  • Ciprofloxacina is not indicated for pediatric patients.

Usage

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ciprofloxacina and other antibacterial drugs, Ciprofloxacina should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Appropriate culture and susceptibility tests should be performed before treatment in order to isolate and identify organisms causing infection and to determine their susceptibility to Ciprofloxacina. Therapy with Ciprofloxacina may be initiated before results of these tests are known; once results become available appropriate therapy should be continued.

As with other drugs, some isolates of Pseudomonas aeruginosa may develop resistance fairly rapidly during treatment with Ciprofloxacina. Culture and susceptibility testing performed periodically during therapy will provide information not only on the therapeutic effect of the antimicrobial agent but also on the possible emergence of bacterial resistance.

How should I use Ciprofloxacina?

Use Ciprofloxacina suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Ciprofloxacina suspension comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Ciprofloxacina suspension refilled.
  • An extra patient leaflet may be available with Ciprofloxacina suspension. Talk to your pharmacist if you have questions about this information.
  • Take Ciprofloxacina suspension by mouth with or without food. The preferred dosing time is 2 hours after a meal.
  • Shake well before each use.
  • Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
  • Take Ciprofloxacina suspension with a full glass of water (8 oz [240 mL]).
  • Drinking extra fluids while you are taking Ciprofloxacina suspension is recommended. Check with your doctor for instructions.
  • If you also take any products containing magnesium, aluminum, calcium, iron, or zinc (eg, antacids, quinapril, vitamins/minerals); didanosine; sucralfate; or bismuth subsalicylate, do not take them within 6 hours before or 2 hours after taking Ciprofloxacina suspension. Check with your doctor if you have questions.
  • If you also take sevelamer, do not take it within 4 hours before or after taking Ciprofloxacina suspension. Check with your doctor if you have questions.
  • Ciprofloxacina suspension works best if it is taken at the same time each day.
  • To clear up your infection completely, take Ciprofloxacina suspension for the full course of treatment. Keep taking it even if you feel better in a few days.
  • Avoid taking Ciprofloxacina suspension with milk or milk products (eg, calcium-enriched juice, yogurt) by themselves. However, taking Ciprofloxacina suspension as part of a full meal that contains milk or milk products is permitted.
  • Do not miss any doses. If you miss a dose of Ciprofloxacina suspension, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Ciprofloxacina suspension.

Uses of Ciprofloxacina in details

infoThere are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Ciprofloxacina is used to treat wide range of bacterial infections including lung or respiratory tract infections, eye infection, bladder and kidney infections, reproductive tract infections, skin and soft tissue infections and bone and joint infections.

Ciprofloxacina description

Ciprofloxacina: Each 250- and 500-mg tablet contains Ciprofloxacin HCl 250 mg and 500 mg, respectively.

Each 50-, 100- and 200-mL vial of infusion solution contains Ciprofloxacin lactate 100 mg, 200 mg and 400 mg, respectively.

Ciprofloxacina tablet also contains microcrystalline cellulose, maize starch, crospovidone, anhydrous colloidal silica, magnesium stearate, hypromellose, macrogol 4000 and titanium dioxide (E171) while the infusion solution also contains lactic acid, sodium chloride, concentrated hydrochloric acid and water for injections.

Ciprofloxacina XR: Each 500 mg tablet contains Ciprofloxacin HCl monohydrate 334.8 mg and Ciprofloxacina hydrous 253 mg, corresponding to Ciprofloxacina 500 mg. Each 1 g tablet contains Ciprofloxacin HCl monohydrate 669.4 mg and Ciprofloxacina hydrate 506 mg, corresponding to Ciprofloxacina 1000 mg.

Ciprofloxacina XR also contains the following excipients: Crospovidone, magnesium stearate, anhydrous colloidal silica, succinic acid, hypromellose, macrogol 3350, titanium dioxide and purified water in bulk.

Ciprofloxacina dosage

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Dosage

Ciprofloxacina and Ciprofloxacina immediate-release tablets are not interchangeable. Ciprofloxacina should be administered orally once daily (Table 1).

Table 1: Dosage Guidelines

Indication

Dose

Frequency

Usual Duration

Uncomplicated Urinary Tract Infection (Acute Cystitis)

500 mg

every 24 hours

3 Days

Complicated Urinary Tract Infection and Acute Uncomplicated Pyelonephritis

1000 mg

every 24 hours

7–14 Days

Patients whose therapy is started with Ciprofloxacina IV for UTIs may be switched to Ciprofloxacina when clinically indicated at the discretion of the physician.

Administration

Ciprofloxacina tablets should be taken whole and not split, crushed, or chewed.
Ciprofloxacina should be administered at least 2 hours before or 6 hours after antacids containing magnesium or aluminum, polymeric phosphate binders (for example, sevelamer, lanthanum carbonate), as well as sucralfate, VIDEX® (didanosine) chewable/buffered tablets or pediatric powder, other highly buffered drugs, metal cations such as iron, and multivitamin preparations with zinc.
Concomitant administration of Ciprofloxacina with dairy products (like milk or yogurt) or with calcium-fortified products alone should be avoided since decreased absorption is possible. A 2-hour window between substantial calcium intake (greater than 800 mg) and dosing with Ciprofloxacina is recommended.

Adequate hydration of patients receiving Ciprofloxacina should be maintained to prevent the formation of highly concentrated urine. Crystalluria has been reported with quinolones.

Impaired Renal Function

In patients with cUTI and acute uncomplicated pyelonephritis with a creatinine clearance of ≤ 30 mL/min, the dose of Ciprofloxacina should be reduced from 1000 mg to 500 mg daily. The use of Ciprofloxacina 1000 mg XR tablets is not recommended in this patient population.
For patients on hemodialysis or peritoneal dialysis, administer Ciprofloxacina after the dialysis procedure is completed (maximum dose should be Ciprofloxacina 500 mg XR every 24 hours). The use of Ciprofloxacina 1000 mg XR is not recommended in this patient population.
For patients on continuous ambulatory peritoneal dialysis (CAPD), the maximum dose should be 500 mg every 24 hours.

Ciprofloxacina interactions

See also:
What other drugs will affect Ciprofloxacina?

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Theophylline

As with some other quinolones, concurrent administration of Ciprofloxacina with theophylline may lead to elevated serum concentrations of theophylline, which may result in an increased risk of a patient developing central nervous system (CNS) or other adverse reactions. If concomitant use cannot be avoided, serum concentrations of theophylline should be monitored and dosage adjustments made as appropriate.

Antacids and Other Products Containing Multivalent Cations

Concurrent administration of quinolones, including Ciprofloxacina, with multivalent cation-containing products such as magnesium or aluminum antacids, sucralfate, VIDEX® chewable/buffered tablets or pediatric powder, or products containing calcium, iron, or zinc may substantially decrease the absorption of Ciprofloxacina. Ciprofloxacina (Ciprofloxacina hcl) should be given either 2 hours after or at least 4 hours before these products. This time window is different than for other oral formulations of Ciprofloxacina, which are usually administered 2 hours before or 6 hours after antacids.

Calcium-containing Beverages

Concomitant administration of Ciprofloxacina with milk products or calcium-fortified juices alone should be avoided since decreased absorption of Ciprofloxacina is possible.

Warfarin

Quinolones, including Ciprofloxacina, have been reported to enhance the effects of the oral anticoagulant warfarin or its derivatives. Prothrombin time, International Normalized Ratio (INR), or other suitable anticoagulation tests should be monitored if Ciprofloxacina (Ciprofloxacina hcl) is administered concomitantly with warfarin or other oral anticoagulants. Patients should also be monitored for evidence of bleeding.

Cyclosporine

Some quinolones, including Ciprofloxacina, have been associated with transient elevations in serum creatinine in patients receiving cyclosporine concomitantly. Cyclosporine whole blood trough concentrations should be monitored when given concomitantly with Ciprofloxacina (Ciprofloxacina hcl).

Methotrexate

Renal tubular transport of methotrexate may be inhibited by concomitant administration of Ciprofloxacina, potentially leading to increased plasma concentrations of methotrexate. This might increase the risk of methotrexate toxic reactions. Therefore, patients under methotrexate therapy should be carefully monitored when concomitant Ciprofloxacina therapy is indicated.

Phenytoin

Altered serum concentrations of phenytoin (increased and decreased) have been reported in patients receiving concomitant Ciprofloxacina. Phenytoin serum concentrations should be monitored when given concomitantly with Ciprofloxacina (Ciprofloxacina hcl).

Glyburide

The concomitant administration of Ciprofloxacina with the sulfonylurea glyburide has, on rare occasions, resulted in severe hypoglycemia.

Non-steroidal Anti-inflammatory Drugs (NSAIDs), but not Aspirin

NSAIDs in combination with very high doses of quinolones have been shown to provoke convulsions in nonclinical studies [see Nonclinical Toxicology.

Caffeine

Some quinolones, including Ciprofloxacina, have been shown to interfere with the metabolism of caffeine. This may lead to reduced clearance of caffeine and prolongation of the serum half-life of caffeine.

Probenecid

Probenecid interferes with renal tubular secretion of Ciprofloxacina and produces increased concentrations of Ciprofloxacina in serum.

Ciprofloxacina side effects

See also:
What are the possible side effects of Ciprofloxacina?

Serious and Otherwise Important Adverse Reactions

The following serious and otherwise important adverse drug reactions are discussed in greater detail in other sections of labeling:

  • Tendon Effects
  • Hypersensitivity Reactions
  • Other Serious and Sometimes Fatal Reactions
  • Central Nervous System Effects
  • Clostridium difficile-Associated Diarrhea
  • Peripheral Neuropathy
  • Photosensitivity/Phototoxicity
  • Development of Drug Resistant Bacteria

Crystalluria and cylindruria have been reported with quinolones, including Ciprofloxacina. Therefore, adequate hydration of patients receiving Ciprofloxacina (Ciprofloxacina hcl) should be maintained to prevent the formation of highly concentrated urine.

Clinical Trial Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The data described below reflect exposure to Ciprofloxacina (Ciprofloxacina hcl) in 524 patients in one clinical trial. The population studied had a mean age of 39 years (approximately 93.4% of the population were < 65 years of age), 100% were female, 77% were Caucasian and 7.4% were Black. Patients received Ciprofloxacina (Ciprofloxacina hcl) 500 mg once daily for 3 days. Patients were followed for approximately 5 weeks after the end of study drug dosing.

Discontinuation of Ciprofloxacina (Ciprofloxacina hcl) occurred in 1.4% of patients. Each of the discontinuations were for a different adverse reactions. Refer to Table 1.

The most common adverse reactions ( ≥ 2%) were fungal infection, nasopharyngitis, headache, and micturition urgency.

Table 1: Adverse reactions (regardless of relationship to study drug) occurring in ≥ 1% of Ciprofloxacina (Ciprofloxacina hcl) -treated patients (500 mg once daily for 3 days) during the entire study period compared to Ciprofloxacina-immediate release tablets (250 mg twice daily for 3 days)

Adverse Reaction Ciprofloxacina Ciprofloxacina-immediate release tablets
Nausea 1.4 2.4
Abdominal pain 1.7 1.2
Suprapubic pain 1.4 0.6
Urinary tract infection 10.8 9.8
Fungal infection 2.7 1.8
Upper respiratory tract infection 1.4 2.9
Back pain 1.7 1.6
Headache 2.3 3.9
Micturition urgency 1.9 1.0
Urinary frequency 1.4 1.0
Nasopharyngitis 2.7 1.4
Pharyngitis 1.2 1.0

The incidence of adverse events (regardless of relationship to study drug) reported for at least 1% of patients treated with Ciprofloxacina (Ciprofloxacina hcl) during study drug treatment and up to 3 days after study drug was headache (1.5%).

Less common reactions, occurring at any time during the study in less than 1% of Ciprofloxacina (Ciprofloxacina hcl) -treated patients were:

  • Cardiac Disorders: ventricular bigeminy.
  • Immune System Disorders: hypersensitivity.
  • Gastrointestinal Disorders: abdominal pain, nausea, diarrhea, dyspepsia, aggravated irritable bowel syndrome, lower abdominal pain, vomiting.
  • General Disorders: suprapubic pain, fatigue, pain, rigors, tenderness.
  • Infections and Infestations: urinary tract infection, fungal vaginosis, bacterial vaginitis, vaginal candidiasis, vaginal infection, vaginitis.
  • Investigations: blood bilirubin increased, alanine aminotransferase increased, abdominal aortic bruit, aspartate aminotransferase increased, body temperature increased.
  • Musculoskeletal and Connective Tissue Disorders: joint swelling, muscle spasms, night cramps.
  • Nervous System Disorders: headache, dizziness, disturbance in attention, paresthesia.
  • Renal and Urinary Disorders: micturition urgency, dysuria, urinary frequency, abnormal urine odor, hematuria.
  • Reproductive System and Breast Disorders: female genital pruritus.
  • Respiratory, Thoracic, and Mediastinal Disorders: dyspnea.
  • Skin/Subcutaneous Tissue Disorders: rash, photosensitivity/ phototoxicity reaction, pruritus, urticaria.

Adverse Reactions Reported with Other Systemic Formulations of Ciprofloxacina

In addition, to the adverse reactions reported with Ciprofloxacina (Ciprofloxacina hcl), the following adverse reactions have been reported during clinical trials and from worldwide post-marketing experience with other systemic formulations of Ciprofloxacina (includes all dosages and indications).

Because these reactions have been reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or a causal relationship to drug exposure. Abnormal gait, achiness, acidosis, agitation, agranulocytosis, allergic reactions (ranging from urticaria to anaphylactic reactions), amylase increase, anemia, angina pectoris, angioedema, anosmia, anxiety, arrhythmia, arthralgia, ataxia, atrial flutter, bleeding diathesis, blurred vision, bronchospasm, C. difficile associated diarrhea, candidiasis (cutaneous, oral), candiduria, cardiac murmur, cardiopulmonary arrest, cardiovascular collapse, cerebral thrombosis, chills, cholestatic jaundice, chromatopsia, confusion, convulsion, delirium, depression, diplopia, drowsiness, dysphagia, dyspnea, edema (conjunctivae, face, hands, laryngeal, lips, lower extremities, neck, pulmonary), epistaxis, erythema multiforme, erythema nodosum, exfoliative dermatitis, fever, fixed eruptions, flushing, gastrointestinal bleeding, gout (flare up), grand mal convulsion, gynecomastia, hallucinations, hearing loss, hematuria, hemolytic anemia, hemoptysis, hemorrhagic cystitis, hepatic failure (including fatal cases), hepatic necrosis, hepatitis, hiccup, hyperesthesia, hyperpigmentation, hypertension, hypertonia, hypoesthesia, hypotension, ileus, insomnia, interstitial nephritis, intestinal perforation, jaundice, joint stiffness, lethargy, lightheadedness, lipase increase, lymphadenopathy, malaise, manic reaction, marrow depression, migraine, moniliasis (oral, gastrointestinal, vaginal), mouth dryness, myalgia, myasthenia, myasthenia gravis (possible exacerbation), myocardial infarction, myoclonus, nephritis, nightmares, nystagmus, oral ulceration, pain (arm, back, breast, chest, epigastric, eye, extremities, foot, jaw, neck, oral mucosa), palpitation, pancreatitis, pancytopenia, paranoia, paresthesia, peripheral neuropathy, perspiration (increased), petechia, phlebitis, phobia, photosensitivity/phototoxicity reaction pleural effusion, polyuria, postural hypotension, prothrombin time prolongation, pseudomembranous colitis (the onset of symptoms may occur during or after antimicrobial treatment), pulmonary embolism, purpura, renal calculi, renal failure, respiratory arrest, respiratory distress, restlessness, serum sickness-like reaction, Stevens-Johnson syndrome, sweating, syncope, tachycardia, taste loss, tendonitis, tendon rupture, tinnitus, torsade de pointes, toxic epidermal necrolysis, toxic psychosis, tremor, twitching, unresponsiveness, urethral bleeding, urinary retention, urination (frequent), vaginal pruritus, vasculitis, ventricular ectopy, vesicles, visual acuity (decreased), visual disturbances (flashing lights, change in color perception, overbrightness of lights), weakness.

The following adverse laboratory changes, in alphabetical order, regardless of incidence or relationship to drug, have been reported in patients given Ciprofloxacina (includes all formulations, all dosages, all drug-therapy durations, and all indications):

Decreases in blood glucose, BUN, hematocrit, hemoglobin, leukocyte counts, platelet counts, prothrombin time, serum albumin, serum potassium, total serum protein, uric acid.

Increases in alkaline phosphatase, ALT (SGPT), AST (SGOT), atypical lymphocyte counts, blood glucose, blood monocytes, BUN, cholesterol, eosinophils counts, LDH, platelet counts, prothrombin time, sedimentation rate, serum amylase, serum bilirubin, serum calcium, serum cholesterol, serum creatinine phosphokinase, serum creatinine, serum gamma-glutamyl transpeptidase (GGT), serum potassium, serum theophylline (in patients receiving theophylline concomitantly), serum triglycerides, uric acid.

Others: albuminuria, change in serum phenytoin, crystalluria, cylindruria, immature WBCs, leukocytosis, methemaglobinemia, pancytopenia.

Ciprofloxacina contraindications

See also:
What is the most important information I should know about Ciprofloxacina?

You should not use this medication if you are taking tizanidine (Zanaflex), if you have a history of myasthenia gravis, or if you are allergic to Ciprofloxacina or similar antibiotics such as gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and others.

Before taking Ciprofloxacina, tell your doctor if you have a heart rhythm disorder, kidney or liver disease, joint problems, diabetes, muscle weakness or trouble breathing, a condition called pseudotumor cerebri, a history of seizures, a history of head injury or brain tumor, low levels of potassium in your blood, a personal or family history of Long QT syndrome, or if you have ever had an allergic reaction to an antibiotic.

Do not take Ciprofloxacina with dairy products such as milk or yogurt, or with calcium-fortified juice.

Avoid taking antacids, vitamin or mineral supplements, sucralfate (Carafate), or didanosine (Videx) powder or chewable tablets within 6 hours before or 2 hours after you take Ciprofloxacina.

Ciprofloxacina may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. Stop taking Ciprofloxacina and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.



Active ingredient matches for Ciprofloxacina:

Ciprofloxacin in Brazil, Colombia, Peru, Venezuela.


List of Ciprofloxacina substitutes (brand and generic names)

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References

  1. DailyMed. "CIPROFLOXACIN; DEXAMETHASONE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "ciprofloxacin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "ciprofloxacin". http://www.drugbank.ca/drugs/DB00537 (accessed September 17, 2018).

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